Bladder Cancer

Cancer Monthly > Cancer Basics > Bladder Cancer

Introduction

Bladder cancer is a cancer that starts in the bladder. It may be called transitional cell carcinoma of the bladder or urothelial cancer. The tumors may be further classified based on the way they grow. Papillary tumors are described as having a “wart-like appearance” and are attached to a stalk. Nonpapillary (sessile) tumors are less common, but they are generally more invasive.

Symptoms of Bladder Cancer

Symptoms of bladder cancer may include: abdominal pain, blood in the urine, bone pain or tenderness, fatigue, painful or frequent urination, or incontinence. Diagnosis of bladder cancer is based on a physical exam (which may include a rectal and pelvic exam) and other tests. The tests may be comprised of: abdominal CT scan, cystoscopy (examining the inside of the bladder with a camera), bladder biopsy (usually performed during cystoscopy), intravenous pyelogram, and urinalysis.

If tests confirm bladder cancer, additional tests are performed to see if the cancer has spread. This is called staging as shown as the examples below:

Stage	Description
0	Noninvasive tumors that are only in the bladder lining.
I	Tumor goes through the bladder lining, but does not reach the muscle layer of the bladder.
II	Tumor goes into the muscle layer of the bladder
III	Tumor goes past the muscle layer into tissue surrounding the bladder.
IV	Tumor has spread to neighboring lymph nodes or to distant sites (metastatic disease).

Treatment for Bladder Cancer

Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health. Bladder Cancer

Treatments for stage 0 and stage I bladder cancer usually include: surgery to remove the tumor without removing the rest of the bladder and chemotherapy or immunotherapy directly into the bladder. Treatments for stage II and stage III bladder usually include: surgery to remove the entire bladder (radical cystectomy) or to remove only part of the bladder, followed by radiation and/or chemotherapy. Most patients with stage IV tumors cannot be cured and surgery is not appropriate. In these patients, chemotherapy is often considered. Chemotherapy may be given to patients with stage II and III disease either before or after surgery to help prevent the tumor from returning.

Many bladder cancers are often treated with immunotherapy. In this treatment, a medication is used to trigger your immune system to recognize and attack the cancer cells. Immunotherapy for bladder cancer is usually performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG). If BCG does not work, patients may receive interferon.

Treatment Results

Outcome for bladder cancer depends on the initial stage and response to treatment. The outlook for stage 0 or I cancers is good. Although the risk of the cancer returning is high, many bladder cancers that return can be surgically removed and cured. The cure rates for people with stage III tumors are less than 50%. Patients with stage IV bladder cancer are rarely cured using conventional therapies.

Causes of Bladder Cancer

There are a variety of potential causes of Bladder Cancer. A number of scientists now believe that a drug called Actos may be responsible for a number of cases. To learn more about what may have caused your bladder cancer click here for more information.